Background: There are a shortage of assessment tools that can be used to evaluate the pragmatic skills of Icelandic-speaking children. Standardised tests of language skills provide limited information about a child’s communicative behaviour in real-life situations. Consequently, speech-language pathologists (SLPs) in Iceland do not have the necessary tools to evaluate one of the three major domains of language: language use. This study describes the evaluation of the Focus on Communication in Children under Six (FOCUS) in Icelandic (FOCUS-ÍS) as a tool to meet this need. The FOCUS items are aligned with the International Classification of Functioning, Disability and Health for Children and Youth (ICF-CY).

Aim: To examine the reliability and validity of FOCUS-ÍS for Icelandic children aged 4;0-4;11.

Method: Information about children’s language skills was collected from parent-completed questionnaires (n = 120; FOCUS-ÍS, Strength and Difficulties Questionnaire [SDQ], Intelligibility in Context Scale [ICS], and Children’s Communication Checklist-2 [CCC-2]) and a standardised language assessment Málfærni eldri leikskólabarna [MELB] was administered to children (n = 64). Relationship between the FOCUS-ÍS total score and subtest scores and other tests/questionnaires was computed.

Results: The FOCUS-ÍS had high internal reliability (total and subtest scores). There was good correlation between the two FOCUS-ÍS subscales (Body Structure, Activities and Participation) and the CCC-2, SDQ, ICS, and MELB showing construct validity. A strong correlation between MELB and FOCUS-ÍS showed convergent validity.

Conclusions: The FOCUS-ÍS shows high internal reliability, evidence of construct validity and convergent validity for FOCUS-ÍS total and profile scores. FOCUS-ÍS is a reliable tool with strong psychometric properties for children aged 4;0-4;11. Further investigation of FOCUS-ÍS is needed for a broader range of ages.

Implications for children and families: Children can demonstrate different communication behaviour, depending on the setting. Valid and reliable parent-report questionnaires give information about communication behaviour in a range of settings and allows for evaluation of language use in real-life situations.

Implications for practitioners: The FOCUS-ÍS is a reliable tool for Icelandic SLPs to use for examining functional communication behaviour of children aged 4;0-4;11. Examining the validity and reliability of translated assessments is essential to ensuring the provision of high-quality and evidence-based services.

Key words: Focus on the Outcomes of Communication Under Six (FOCUS), functional outcome, parent-report, communication, ICF-CY, communicative participation

This presentation relates to the following United Nations Sustainable Development Goals: 

• SDG 3: Good Health and Well-being
• SDG 4: Quality Education
• SDG 10: Reduced Inequality